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Methotrexate pneumonitis — SCE Rheumatology MCQ

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HardRheumatoid arthritisMethotrexate pneumonitisSCE Rheumatology

A patient taking methotrexate develops acute dry cough, hypoxaemia and diffuse bilateral ground-glass change. Cultures are negative and BAL shows lymphocytosis. What is the immediate medication action?

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Correct answer: A — Stop methotrexate and assess urgently for drug pneumonitis

Methotrexate pneumonitis is an uncommon but potentially serious hypersensitivity-like lung injury. The drug should be stopped while infection, oedema and RA-associated ILD are evaluated; clinically important disease commonly requires specialist corticosteroid treatment.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/musculoskeletal-conditions